Various conditions, illness, and/or injuries that affect the brain require surgical procedures to provide access to the brain in order to treat the affected area. For example, many brain tumors are life-threatening and require a surgical procedure to access and remove at least a portion of the tumor. For primary brain tumors, an attempt at maximal surgical resection is often the preferred treatment, usually followed by adjuvant chemotherapy and radiation therapy. For brain metastases, resection is often recommended for large, symptomatic metastases as well as for single metastases in patients with otherwise high functional status. Appropriate tumor removal facilitates neurologic recovery, functional recovery, and sometimes survival.
However, safely providing access to such treatment areas can be challenging. For example, the vast majority of intraparenchymal brain tumors are surrounded by a “cuff” of overlying brain cortex as well as subcortical white matter, which in turn, surrounds the actual tumor. Much of the morbidity and risk inherent to brain tumor surgery is related to the manipulation and dissection of this tissue. In addition, the amount of dissection of overlying brain increases with increasing lesional depth. As a result, the risk of neurological injury and surgical complications can be even greater for deep-seated brain tumors.